Although the rate of mental health dif®culties is lower in the older adult population2 when compared with earlier adult stages, it remains a signi®cant issue for this group (Smyer & Qualls, 1999; Gatz et al., 1997). There are many factors that may complicate the assessment and intervention process (Stanley, 2001). In addition, the literature suggests that many older adults with mental health dif®culties are not getting the treatment that they require (Nordhus et al., 1998). The remit of the present chapter is to consider the assessment of mental health issues, other than depression and dementia that appear to dominate the geropsychology literature. Within this chapter, we visit the various approaches and frameworks relevant to the assessment of mental health dif®culties in older adults, and examine the contextual factors that are of signi®cance in their assessment. Issues of effective evidence-based practice and service provision will be considered.